BackgroundPrevious studies have shown that unsafe injection practice is a major public health problem in Nepal but did not quantify the problem. The present community-based study was planned to: 1 quantify injection usage, 2 identify injection providers, 3 explore differences, if any, in injection usage and injection providers, and 4 study and compare people’s knowledge and perception about injections between the urban and rural areas of Kaski district.

MethodsA descriptive, cross-sectional mixed-methods study was conducted from July to November 2012, using a questionnaire based survey and focus group discussions FGDs. A semi-structured questionnaire advocated by the World Health Organization was modified and administered to household heads and injection receivers in selected households and the FGDs were conducted using a topic guide. The district was divided into urban and rural areas and 300 households from each area were selected. Twenty FGDs were held.

ResultsIn 218 households 36.33% 99 in urban and 119 in rural one or more members received at least one injection. During the three month recall period, 258 subjects 10.44% reported receiving injections with a median of two injections. The average number of injections per person per year was calculated to be 2.37. Health care workers 34.8%, staff of medical dispensaries 37.7%, physicians 25.2%, and traditional healers 2.3% were consulted by the respondents for their basic health care needs and for injections. Compared to urban respondents, more rural respondents preferred injections for fever p ConclusionsLess preference for injections and high awareness about the association between injections and injection-borne infections among the general population is encouraging for safe injection practice. However, respondents were not aware of the importance of having qualified injection providers for safe injections and were receiving injections from unqualified personnel.